Background: Childhood obesity is a major public health problem that has reached epidemic proportions worldwide due to its increasing prevalence. Many studies have shown that endothelial damage starts even during childhood if obesity is present. Recent studies reveal disturbances in both cardiac function and structure of obese children.Methods: This was a prospective observational case-control study. Children of 6 to 16 years of age were recruited. Seventy-five (75) children belonged to the group with increased body weight (both overweight and obese), and forty-nine (49) were normal weight children that were age-, Tanner-stage-, and sex-matched. Both medical and sociodemographic history were taken. The candidates underwent physical examination, laboratory tests with metabolic profile, bone metabolism, and inflammatory markers. Endothelial dysfunction and early vascular changes were evaluated by ultrasound assessment of flow-mediated dilation (FMD) of the brachial artery, and carotid intima-media thickness (cIMT), respectively. Finally, an echocardiogram for the assessment of heart dimensions and function was performed.Results: The two groups were found to be significantly different in the following laboratory markers: ALT (p<0.001), GGT (p<0.001), insulin (p=0.009), TCHOL (p<0.001), LDL (p<0.001), apoB (p=0.017). The two groups also presented a significant difference in both endothelial function assessed by FMD (p=0.006) and endothelial structure assessed by IMT (p<0.001). Finally, they were found to differ in epicardial fat (p<0.001) and diastolic function assessed by E/e’ (p=0.005).Conclusions: The impact of increased body weight on the heart and endothelium was assessed in combination with metabolic profile of the children and it was found that even from this young age both endothelium and cardiac function present significant changes in this population. The results of this study highlight the need for appropriate intervention in order to minimize the cardiovascular dysfunction in obese and overweight children.
